4.5 Article

Informed choice and attitudes regarding a genomic test to predict risk of colorectal cancer in general practice

Journal

PATIENT EDUCATION AND COUNSELING
Volume 105, Issue 4, Pages 987-995

Publisher

ELSEVIER IRELAND LTD
DOI: 10.1016/j.pec.2021.08.008

Keywords

Available online xxxx; Cancer screening; Risk prediction; Colorectal cancer; Polygenic risk score; Clinical utility; Genomics

Funding

  1. Cancer Research UK [C8640/A23385]
  2. Australian Government Research Training Program (RTP) Scholarship
  3. NHMRC
  4. Primary Care Collaborative Cancer Clinical Trials Group (PC4)

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This study examined informed decision-making and attitudes towards genomic testing for colorectal cancer risk in primary care. The results showed that genomic testing did not pose significant concern to most patients, with positive attitudes being the most prevalent. However, some participants expressed negative attitudes, and many were indifferent towards the test.
Objective: A genomic test to predict personal risk of colorectal cancer (CRC) that targets screening and could be feasibly implemented in primary care. We explored informed decision-making and attitudes towards genomic testing in this setting.Methods: A CRC genomic test was offered to 150 general practice patients with brief discussion of its implications. We measured informed choice about the test, consisting knowledge, attitudes and test uptake. Sixteen purposively-sampled participants were interviewed.Results: Of 150, 142 (95%) completed the informed choice measure and of 27 invited, 16 (59%) completed an interview. 73% made an informed choice about the test. Interviews revealed that participants with inadequate knowledge on the informed choice scale still understood the gist of the test. While positive attitudes were most prevalent, some had concerns, and many were indifferent to the test. Positive attitudes included: that risk information could facilitate risk reduction; negative attitudes included: that risk results could cause worry and be used for insurance discrimination; indifferent attitudes included: that the test seemed benign and it was easy to do. Conclusions: Our study adds to the evidence that genomic tests for CRC risk do not pose significant concern to patients in community settings. Practice implications: As genomic tests become more prevalent, this study's findings can be used to facilitate informed decision-making and ensure equitable access.(c) 2021 Elsevier B.V. All rights reserved.

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